Provider Demographics
NPI:1205027224
Name:ACCENT PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ACCENT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUPLESSIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:910-536-5667
Mailing Address - Street 1:1115 MILITARY CUTOFF RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3970
Mailing Address - Country:US
Mailing Address - Phone:910-536-5667
Mailing Address - Fax:910-256-4777
Practice Address - Street 1:1115 MILITARY CUTOFF RD
Practice Address - Street 2:SUITE A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3970
Practice Address - Country:US
Practice Address - Phone:910-536-5667
Practice Address - Fax:910-256-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6968225100000X
NC11549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC113670557OtherCIGNA
NC025FROtherBCBS NC
NC025FROtherBCBS NC